ASSH DVD Library #7: Other Joints


Published by: American Society for Surgery of the Hand

1. The Treatment of Unstable Proximal Interphalangeal Joint Fractures: How to Apply and Use a Dynamic Mini-external Fixator - Joseph F. Slade III, MD; Scott W. Wolfe, MD; Andrew Gutow, MD (17:30) Unstable fracture dislocations of the proximal interphalangeal joint are difficult to treat and often lead to recurrent dislocation resulting in pain and stiffness. Robertson, in 1946, advocated traction in the treatment of these fractures. But Schenk, concerned about stiffness, added early passive motion to the treatment regimen using a hermoplastic hand splint. Recently, multiple authors have reported good results using mini-external fixators. This video describes the indications and application of a dynamic traction internal fixator. The anatomy of the PIP joint and the pathophysiology of the fracture is discussed. Indications for dynamic traction splinting and early active motion are described. Detailed construction of the mini-external fixator is demonstrated in a cadaveric lab and in the operating room. A clinical case illustrates the fixator and the post-op therapy protocol. Produced in 1996 by Joseph F. Slade III, MD, Scott W. Wolfe, MD, and Andrew Gutow, MD.

2. A Lateral Collateral Preserving Approach for Surgical Correction of the Stiff Elbow - Hill Hastings II, MD; Mark S. Cohen, MD (26:00)  This video presents the method for contracture release and elbow debridement for correction of extension deficit due to posterior bony abutment and anterior capsular contracture along with the correction of flexion deficit secondary to anterior bony impingement and posterior contracture. The lateral collateral annular complex preserving surgical approach is presented and a clinical example shown with ankylosis of the elbow combined with anterolateral and posterior heterotopic ossification. The important aspects of the surgical technique including continuous axillary brachial plexus blockade, surgical exposure, steps of contracture release, and postoperative therapy are demonstrated and clinical results are presented. Produced in 1999 by Hill Hastings, II MD, and Mark S. Cohen, MD.

3. Precision Oblique Ulnar Shortening Osteotomy Using the ROS System - John M. Rayhack, MD (25:00)

4. Radial Carpal Arthroscopy: Technique and Comparison to Arthrography - James H. Roth, MD (30:00) This videotape presents a technique of radiocarpal arthroscopy along with the results of a study comparing radiocarpal arthrography with arthroscopy in the diagnosis of chronic ulnar wrist pain. Thirty-seven consecutive patients with ulnar wrist pain, but normal routine and stress radiographs, had dynamic and static radiocarpal arthrograms and arthroscopy performed. Findings are discussed, leading to the conclusion that radiocarpal arthroscopy is superior to arthrography in the diagnosis of intra-articular causes of chronic ulnar wrist pain. Produced by James H. Roth, MD.


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